Provider Demographics
NPI:1700819828
Name:KEYES, KIMBERLY SUSAN (PA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:SUSAN
Last Name:KEYES
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5949 BUFORD HWY
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2472
Mailing Address - Country:US
Mailing Address - Phone:678-280-6630
Mailing Address - Fax:648-280-6635
Practice Address - Street 1:355 ABBOTT ST STE 100
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4484
Practice Address - Country:US
Practice Address - Phone:831-751-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPA5363363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical